改良式定位联合“三明治点赞法”在新生儿股静脉穿刺中按压止血效果研究

Application of modified positioning combined with“sandwich point pressure”in neonatal femoral venous puncture

目的:研究改良式定位联合“三明治点赞法”在新生儿股静脉穿刺中的应用效果。方法:将152例股静脉穿刺采血新生儿按止血方式不同分为研究组和对照组,每组各76例。对照组使用常规穿刺股静脉按压止血护理,研究组使用改良式定位联合“三明治式点赞法”进行股静脉穿刺按压止血;比较两组新生儿采血情况(一次性穿刺采血成功率、采血耗时、止血耗时)、疼痛情况[新生儿面部编码系统(NFCS)、新生儿疼痛评估量表(NIPS)、啼哭持续时间]、皮肤不良反应总发生率(淤血、血肿、穿刺点持续渗血)等;比较两组新生儿采血前后生命指征[呼吸频率、血氧饱和度(SpO_(2))、心率(HR)]。结果:研究组新生儿一次性穿刺成功率高于对照组(P<0.05);采血耗时、止血耗时和NFCS、NIPS评分、啼哭持续时间、淤血、血肿、穿刺点持续渗血总发生率均低于对照组(P<0.05);采血后两组新生儿呼吸频率、SpO_(2)、HR均高于采血前,且研究组略低于对照组,但差异均无统计学意义(P>0.05)。结论:改良式定位联合“三明治式点赞法”用于新生儿股静脉穿刺后按压止血可提高一次性穿刺采血成功率,缩短采血耗时,减轻新生儿疼痛度,降低穿刺采血皮肤不良反应发生风险。

Objective:To study the application effects of modified positioning combined with“sandwich point pressure”on femoral venous puncture in neonates.Methods:152 neonates undergoing femoral venous puncture blood collection in the hospital were selected and divided into study group and control group according to the different hemostatic methods,with 76 cases in each group.The control group received conventional femoral venous compression hemostasis nursing,and the study group used modified positioning combined with“sandwich pointpressure”for femoral venous puncture compression hemostasis.The blood collection[success rate of one-time puncture blood collection,blood collection time,hemostasis time],pain status[Neonatal Facial Coding System(NFCS),Neonatal Infant Pain Scale(NIPS),duration of crying]and total incidence rate of skin adverse reactions[congestion,hematoma,continuous bleeding at the puncture point]were compared between the two groups of neonates.The vital signs[respiratory rate,blood oxygen saturation(SpO_(2)),heart rate(HR)]of the two groups of neonates were compared before and after blood collection.Results:The success rate of one-time puncture of neonates in study group was higher than that in control group(P<0.05).The blood collection time,hemostasis time,NFCS score,NIPS score,duration of crying and total incidence rate of congestion,hematoma and continuous bleeding at the puncture point were shorter or lower than those in control group(P<0.05).After blood collection,the respiratory rate,SpO_(2)and HR of the two groups of neonates were higher than those before blood collection,and the study group was slightly lower than the control group,but the difference was not statistically significant.(P>0.05).Conclusion:Modified positioning combined with“sandwich point pressure”for compression hemostasis after femoral venous puncture in neonates can increase the success rate of one-time puncture blood collection,shorten the time of blood collection,relieve the pain of neonates,and reduce therisk of skinadverse reactions due to puncture blood collection.